Articles: mechanical-ventilation.
-
Critical care medicine · May 2018
Equilibration Time Required for Respiratory System Compliance and Oxygenation Response Following Changes in Positive End-Expiratory Pressure in Mechanically Ventilated Children.
Increases in positive end-expiratory pressure are implemented to improve oxygenation through the recruitment and stabilization of collapsed alveoli. However, the time it takes for a positive end-expiratory pressure change to have maximum effect upon oxygenation and pulmonary compliance has not been adequately described in children. Therefore, we sought to quantify the time required for oxygenation and pulmonary system compliance changes in children requiring mechanical ventilation. ⋯ T90 requires 38 and 71 minutes for dynamic pulmonary compliance and oxygenation, respectively; the latter was directly observed to be dependent upon severity of illness. To our knowledge, this is the first report of oxygenation and compliance equilibration data following positive end-expiratory pressure increases in pediatric mechanically ventilated subjects.
-
Editorial Clinical Trial
Frequent Versus Infrequent Monitoring of Endotracheal Tube Cuff Pressures.
Currently there is no accepted standard of practice for the optimal frequency of endotracheal tube cuff pressure monitoring in mechanically ventilated patients. Therefore, we conducted a study to compare infrequent endotracheal tube cuff pressure monitoring (immediately after intubation and when clinically indicated for an observed air leak or due to tube migration) with frequent endotracheal tube cuff pressure monitoring (immediately after intubation, every 8 h, and when clinically indicated). ⋯ More frequent cuff pressure monitoring was not associated with any identifiable clinical outcome benefit.
-
Nursing in critical care · May 2018
Observational StudyNurses' implementation of ventilator-associated pneumonia prevention guidelines: an observational study in Jordan.
Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable. ⋯ Nurses' compliance with ventilator-associated pneumonia prevention guidelines was insufficient. Low nurse-patient ratio and large intensive care unit beds capacity were found to affect nurses' compliance and patients' outcomes. This study expanded knowledge about important aspects of nursing care; nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that affect their compliance. This knowledge can be used by health professional to guide the clinical practice and to improve the quality of care.
-
Randomized Controlled Trial
Comparison of exercise intensity during four early rehabilitation techniques in sedated and ventilated patients in ICU: a randomised cross-over trial.
In the ICU, out-of-bed rehabilitation is often delayed and in-bed exercises are generally low-intensity. Since the majority of rehabilitation is carried out in bed, it is essential to carry out the exercises that have the highest intensity. The aim of this study was to compare the physiological effects of four common types of bed exercise in intubated, sedated patients confined to bed in the ICU, in order to determine which was the most intensive. ⋯ Most bed exercises were low-intensity and induced low levels of muscle work. FES cycling was the only exercise that increased cardiac output and produced sufficient intensity of muscle work. Longer-term studies of the effect of FES cycling on functional outcomes should be carried out.
-
BMC pulmonary medicine · Apr 2018
Comparative StudyComparative bench study evaluation of different infant interfaces for non-invasive ventilation.
To compare, in terms of patient-ventilator interaction and performance, a new nasal mask (Respireo, AirLiquide, FR) with the Endotracheal tube (ET) and a commonly used nasal mask (FPM, Fisher and Paykel, NZ) for delivering Pressure Support Ventilation (PSV) in an infant model of Acute Respiratory Failure (ARF). ⋯ The ET showed a better patient-ventilator interaction and performance compared to both the nasal masks. Despite the higher internal volume, Respireo showed a trend toward an increase of the delivered tidal volume; globally, its efficiency in terms of patient-ventilator interaction was comparable to the FPM, which is the infant NIV mask characterized by the smaller internal volume among the (few) models on the market.